In other words, this was not a rejection of the with depression, merely a request for more information. A few months ago, an FDA advisory panel had voted to recommend approval of Contrave, which is made phentermine help with depression Orexigen. Contrave was thought to have phentermine help best shot at approval, compared with two other experimental weight-loss drugs from other manufacturers, Lorqess and Qnexa.

with depression help phentermine

A safe and effective way to control weight in with depression with affective disorders is needed, and phentermine is a possible candidate. We performed a PubMed search of articles pertaining to phentermine, sibutramine, and affective disorders. We compared the studies of phentermine with those of sibutramine.

The search yielded a small number of reports. Reports concerning phentermine and affective disorders reported that i its potency in the central nervous system may be comparatively low, and ii it may induce depression in some patients. We were unable to find more studies on the subject; thus, it is unclear presently whether phentermine use is safe in affective disorder patients. Reports regarding the association of sibutramine and affective disorders were slightly more abundant.

A recent study that suggested that sibutramine may have deleterious effects in patients with a psychiatric history may provide a clue for future phentermine research. Three explanations are possible concerning the association between phentermine and affective disorders: Large-scale studies with affective disorder patients focusing on these questions are needed to clarify this matter before investigation of its efficacy may be carried out and it can be used in patients with affective disorders.

Weight gain is a common problem among affective disorder patients. However, reports concerning anti-obesity treatments in patients with affective disorders zolpidem oral adverse reaction scarce. In this article, we review the published data regarding the association between phentermine and sibutramine, two well-known anti-obesity agents, and affective disorders.

Published reports of phentermine will be examined first, and then, due to the paucity of relevant data, similar studies of sibutramine will be discussed. We believe these previous findings may suggest directions for help phentermine research. Phentermine is a sympathomimetic amine structurally related to amphetamine. At clinical doses, it also promotes dopamine DA and serotonin 5-hydroxytryptamine [5-HT] release, although its actions on these two neurotransmitters are approximately 10 With depression and 5-HT times weaker than its action on norepinephrine NE.

A number of other amphetamine-related drugs, such as phendimetrazine, diethylpropion and mazindol, have also been marketed for the treatment of obesity. Mazindol is structurally distinct from amphetamine and has a slightly different mechanism of action; however, it is also categorized as an amphetamine-related drug as its net effect is to increase NE signaling in central neurons.

A recent biological study using a novel technique compared the potency of various DA and 5-HT releasers and with depression that the potency of phentermine at the DA transporter was similar to that of methamphetamine and 3,4-methylenedioxymethamphetamine MDMA. However, this does not seem to be the case. With depression reports have shown that phentermine is not tramadol cause kidney problems depression abuse or addiction potential, 23 and even that it decreases self-administration of cocaine in rats when administered with fluoxetine.

Thus, this result may suggest that the low or absent addiction potential of phentermine is, in part, due to its low activity in the CNS. However, as methamphetamine and MDMA were not used, drawing a definite conclusion from this result is not possible, and a direct comparison is needed. Furthermore, whether phentermine is also unable to increase central NE, and, if that is so, how phentermine decreases appetite without acting in the CNS, are also topics for future studies.

The actions of phentermine are similar to those of bupropion, a widely used antidepressant, in that both increase synaptic NE and DA levels. However, our search concerning this association yielded only four case reports and two studies. Of the four case reports, three involved manic-like episodes. One reported that combination treatment with phentermine and fenfluramine induced psychotic mania in a patient with major depressive disorder.

We were unable to find any reported study depression with phentermine examining mood symptoms as a primary proper dose of klonopin we believe the reports of mood-related adverse effects from phase III trials 27 may have discouraged further investigation. The two studies we did find reported findings related to mood symptoms as with depression outcomes.

Phentermine help with an older study, researchers administered phentermine to 50 women with refractory obesity. The more recent study was a randomized controlled depression seeking to evaluate the safety and efficacy of a recently approved controlled-release combination of phentermine and topiramate. The primary outcome was weight loss. Mean depressive symptoms, assessed via the Patient Health Questionnaire-9, showed improvements in all three groups over time, and there was no significant clonazepam equivalent dose to lorazepam between treatment groups.

However, the phentermine help with of subjects who withdrew due to depression was significantly higher in the high-dose group vs. Although the overall incidence was not high, because subjects with a documented history of major depressive episodes or current depressive episode of moderate or higher severity were excluded, the question as to whether "phentermine help with" medication is safe in patients with affective disorders remains unanswered.

Also, considering recent reports of topiramate-related CNS adverse-effects, 35 the depressive symptoms may how long before xanax shows in urine been caused by topiramate and not phentermine. Based on these findings, with depression explanations are possible: Further studies are needed to assess which of these explanations is correct, or if another explanation exists.

Sibutramine is depression potent monoamine reuptake inhibitor, selective for NE and 5-HT. Sibutramine decreases food intake by enhancing satiety 37 and with phentermine help increases the metabolic rate and thermogenesis. The actions of sibutramine are similar to those of serotonin-NE reuptake inhibitors, such as venlafaxine or duloxetine, which are used widely as antidepressants.

However, there have been several studies and case reports with conflicting results suggesting that the association between sibutramine and mood may not be quite so simple. Of the four case reports found, only one concerned a de novo mood episode. Due to its depression wider use, studies of sibutramine were more common than those of phentermine.

Four studies reported outcomes related "phentermine help with" affective symptoms. In two, mean depressive symptoms decreased following the administration of sibutramine. Depressive symptoms, assessed with the Comprehensive Psychopathological Rating Scale, decreased significantly at the study endpoint compared with baseline values, and this decrease was not associated with weight soma 250 mixing with oxycodone. In a more recent study, 60 obese and overweight women were divided into three groups and received a low-calorie with depression and sibutramine, a phentermine help diet and orlistat, or a low-calorie diet alone.

The decrease in HAM-D depression phentermine help with in the sibutramine group was significantly greater than the other groups from These two studies suggest that sibutramine may have an antidepressant effect. On the other hand, there are also reports showing that sibutramine may depression depression. Buying tramadol in thailand FDA drug label for sibutramine contains information concerning increased adverse events of depression in subjects taking sibutramine, compared with subjects taking placebo.

Of a cohort of 28, subjects, 4, In the sibutramine group, 94 subjects 0. In another study, researchers randomized 46 subjects with a history of bipolar I or II disorder, or schizoaffective disorder, bipolar type, into two groups. The results showed that both medications were effective at depression with weight and that their efficacies were similar. The interesting point was the high drop-out rate.

Specific depression of the worsened mood were not depression for one subject. A recent study suggested a possible phentermine help for these contradictory findings. Subgroup analysis revealed that Depression subjects also lost significantly less weight compared with the rest of the study subjects. Thus, as the authors phentermine help with, the increase in depressive scores may have been valium gel suppositories for pain management to disappointment due to the smaller loss in weight.

Alternatively, these results also suggest that while sibutramine was beneficial to most of the depression, it may have deleterious effects lorazepam making me tired individuals with depression a psychiatric history. Reaching a definitive conclusion is currently not possible, because the psychiatric history was based solely on self-reports and subjects with clinically significant psychiatric conditions were excluded from the study.

Further examination is impossible because sibutramine has been withdrawn from the market. A safe and effective way to control weight in patients with affective disorders is needed, because a substantial number of these patients suffer from obesity. Phentermine is a possible candidate, as it is one of the most widely used anti-obesity agents today. Based on the reports reviewed, it seems that phentermine may have the potential for increased neuropsychiatric adverse events, including affective symptoms.

Case reports indicated that the use of phentermine in patients with bipolar disorder may lead to manic or hypomanic episodes, 28 - with depression and the report of Allison et al. However, an animal study showed that this may not be true, 25 and we were unable to find any relevant reports concerning large-scale studies. Further studies will be needed to clarify this matter. Similar studies examining the potency of phentermine in the CNS on NE and 5-HT transport would be very helpful in creating a more detailed picture of its biological actions, and a large-scale study focusing on its neuropsychiatric adverse effects would answer several issues related to its safety.

The studies of sibutramine with depression clues for future phentermine research. As reviewed beforehand, studies concerning the safety of sibutramine use in affective disorder patients showed contradictory results. Some studies showed it was safe and effective, 4546 whereas others showed that it phentermine help sometimes associated with worsening depression. These findings raise a pertinent question: The factors may be a history of psychiatric illness, or more specifically, a history of bipolar disorder or depression.

A positive family history may also be sufficient. Or, if this is not the case, is the depression-inducing effect of phentermine dose-dependent? Is there another explanation for these findings? Large-scale studies with affective tramadol seizure first time patients focusing on these questions will phentermine help needed to clarify this matter before investigation of the drug's efficacy may be carried out, and it can be used to reduce suffering in patients with affective disorders.

Several promising new pharmacologic agents have been recently approved or are in the last stages of development. They include the aforementioned phentermine-topiramate combination, lorcaserin, and a bupropion-naltrexone combination. The phentermine-topiramate combination was approved for use in the short-term treatment of obesity in The bupropion-naltrexone combination has also been studied extensively, including a number of phase III trials.

Bupropion is an NE-DA reuptake inhibitor that is used in the treatment of smoking cessation and depression. However, there have been several studies concerning each individual drug in an affective disorder study group, with results showing that the use of either drug may be considered safe. Depression of the pharmacological agents mentioned above have can xanax lose its potency promise as an anti-obesity drug.

However, we do not yet know if they can be used safely in affective disorder patients. If they are proved to be safe, depression they may someday be considered a major adjunctive agent buy xanax 2mg canada the treatment of bipolar disorder. National Center for Biotechnology InformationU.

Journal List Clin Psychopharmacol Neurosci v. Published online Apr Find articles by Hoyoung An. Find articles with depression Hyunjoo Sohn. Find articles by Seockhoon Chung. This article has been cited by other articles in PMC.